Thank you for your interest in receiving the Moderna COVID-19 vaccine. More information about the vaccine may be found at this link: Moderna Vaccine Fact Sheet.
To apply for an appointment, please fill out and submit this form. Once we receive your information, we will contact you by email to notify you of your appointment date and time, or that you have been placed on a waitlist to receive the vaccine.
Please note that we may only administer the vaccine to people who have been deemed by New York State and New York City to be eligible. You will be required to provide proof of eligibility and submit an electronic form attesting to your eligibility at your appointment. Information about eligibility may be found at this link: NYC COVID-19 Vaccine Eligibility Information. If you are not eligible, please do not schedule an appointment. When you are scheduled for an appointment, you will receive more information about what to bring to your appointment regarding your eligibility.
Also note that it is critical to keep your COVID-19 appointment once it is scheduled, as we cannot dispose of unused doses.
If you have any questions, please contact the Covenant House New York Health Center at (212) 613-0315 or HealthCenter@covenanthouse.org